48例脑梗死患者全脑血管造影分析

Angiographic findings in 48 cases of ischemic stroke

目的观察缺血性卒中脑血管造影显示的血管狭窄或闭塞的比率及分布.方法观察脑梗死48例,头颅CT排除出血、TCD及颈动脉彩超检查疑有动脉狭窄发病1～7天的缺血性卒中患者.全部进行高选择性颈部及颅内血管造影,同步检查正侧位血管造影相和连续动态电影录像,必要时增加检查斜位像.分析血管狭窄部位,受累血管数目及血管狭窄形态.结果血管造影显示75.5%有血管狭窄或闭塞,其中76%为前循环受累,24%后循环受累.9条无临床症状的血管狭窄或闭塞,6%血管造影正常.大脑中动脉和颈内动脉受累最为常见,后循环受累血管中以椎动脉最常见.多部位和多血管受累达41%.发现烟雾病5例(14%),脑血管畸形2例(4.5%).结论脑梗死血管造影显示大部分患者有肯定的脑血管狭窄或闭塞.神经放射介入可有效诊断脑血管病.

Objective To evaluate the frequency and localization of the involved arteries in isehemie stroke, by cerebral vascular angiography. Methods The patients suffered from ischemic stroke 4-30points of NIHSS and cerebral hemorrhage should be excluded by CT scan. All patients tested by TCD and color Doppler Ultrasound suspected arteries stenosis. All subjects underwent high selective angiographies for the observation of aorta, carotid arteries, vertebral, and all the intracranial arteries. The degree of stenosis, the localization and numbers of the arteries involved and the morphology of plague or the stenosis were assessed, Results Angiography showed occlusive findings of cerebral arteries in 75.5% of the patients, among them 76% were located in anterior circulation and 24% were located in posterior. Additional 9 asymptomatic occlusive were found. Angiograms were normal in 6%. The internal carotid and middle cerebral arteries are most frequently involved in this series. The vertebral arteries were the most commonly involved in the posterior circulation. 5 cases of Moyamoya＇s disease. 2 cases of Cerebral Vascular Malformations. Conclusion Most of patients with ischemic stroke were documented with definitive occlusion of cerebral arteries, The options of treatment should be based on the morphology of the involved arteries. interventional neuroradiology was useful for cerebrovascular disease.